Formation and Persistence of Procoagulant and Fibrinolytic Activities in Circulation after Strenuous Physical Exercise

Abstract

SummarySeven healthy male volunteers were subjected to exercise of short (STR; 1.7 km), middle (MTR; 4.8 km) and long (LTR; 10.5 km) term runs at a speed close to maximal capacity. Blood samples were drawnbefore, immediately after exercise and at intervals over the next 10 h. FVTIIR: Ag (von Willebrand factor) rose 2.2–3.2 fold and persisted at higher levels than baseline during the observation time. A spontaneous drop in FVII (p <0.03) was found immediately after STR(13.5 ± 2.5%) and LTR (18.3 ± 2.4%), whereas only a minor decrease (7.5 ± 6.5%) occurred in MTR. The procoagulant activity of monocytesisolated from whole blood exposed to LPS showed a striking enhancement in STR and MTR. An immediate enhancement in fibrinolytic activity was found in all groups (p <0.03) assessed by increased plasma levels of t-PA and shortened whole blood clot lysis time (WBCLT). The transient shortening of WBCLT was succeeded by a tendency to prolongation of the lysis time. A 45-year old male differed markedly from the others by demonstrating an extreme and consistent prolongation of WBCLT. Thus, it hasbeen speculated that strenuous exercise possibly makes a subject more susceptible to a thrombotic event.

Changes in von Willebrand factor and fibrinolysis following a post-exercise cool-down

“…Specifically, vWf:Ag was the same between tests pre-and post-exercise, but following the AC, it was 24% lower than the PC, and 20% lower 1 h post-exercise. The post-exercise elevations in vWf:Ag are similar to previously published studies reporting sustained increases in markers of coagulation potential after acute exercise (Bartsch et al 1990;Hansen et al 1990;Saenko et al 1999).…”

“…During acute exercise in humans, markers of coagulation potential increase and remain elevated for at least 6-10 h following cessation of activity (Hansen et al 1990;Lin et al 1999). Fibrinolysis has been shown to increase with exercise (Andrew et al 1986;Chandler et al 1992;Lin et al 1999;van den Burg et al 1997); however, following maximal exercise, it decreases during the post-exercise period at a faster rate than coagulation potential (Andrew et al 1986;Chandler et al 1992;Hegde et al 2001;van den Burg et al 1997;Weiss et al 1998) and returns to resting levels within 2 h (Lin et al 1999).…”

Systemic inflammation increases shear stress‐induced platelet plug formation measured by the PFA‐100

“…Our results may have two further implications: first, physical exercise and acute smoking also lead to an increase in VWF levels, and also influence platelet function (Hansen et al, 1990;Blann & McCollum, 1993). Therefore, it may be advisable that patients reporting for PFA-100 measurement should minimize exercise and not smoke for at least 24 h before blood sampling.…”

Physical activity and risk of venous thromboembolism. The Tromso study

“…19,26,27 Unfortunately, data on minor injuries were not available for our cohort to test this hypothesis. Furthermore, physical exercise of moderate and high intensity is associated with several immediate alterations in the hemostatic system, such as increased platelet reactivity, 28 shortened bleeding-time, 29 elevated plasma levels of factor VIII, 30 von Willebrand factor, 30,31 and fibrinogen, 32 increased plasma viscosity, 32 increased endogenous thrombin formation assessed by thrombin-antithrombin complex formation, 30 and transient increased fibrinolytic activity associated with increased plasma levels of tissue plasminogen activator 33 with subsequent inhibition of fibrinolytic activity monitored by prolongation of whole blood clot lysis time. These acute prothrombotic changes in the hemostatic system may contribute to the increased risk of acute coronary syndromes associated with physical exertion.…”